Yuniel Hernandez Castillo*
General Surgery, Milton Cato Memorial Hospital, Saint Vincent and the Grenadines, Caribbean
*Corresponding Author: Yuniel Hernandez Castillo,General Surgery, Milton Cato Memorial Hospital, Saint Vincent and the Grenadines, Caribbean.
Received: November 22, 2019; Published: December 04, 2019
Introduction: Elbow dislocations are sometimes associated with neurovascular injuries where brachial artery is the most frequently injured artery requiring emergency and adequate often complex surgical treatment in order to manage their severe complications. The literature consists of only a few limited case reports on associated vascular or neurovascular injuries resulting from this type of trauma with no reference to the particular techniques we combined to treat our patient.
Presentation of Case: We present a Brachial Artery reconstruction in a 31-year-old patient with an Open Complex Right Elbow Dislocation. In the Clinical and Surgical Examination an open wound in the Anterior-Medial Right Antecubital Fossa presented with accompanying Brachial Pedicle all structures Transection was confirm. To repair the Brachial Artery a Substitution By-Pass and End-to-End Anastomosis was conducted using an Autologous Reverse Brachial Vein Conduit graft from the ipsilateral arm under General Anesthesia. For the Wound Closure a Rotational Skin and subcutaneous Fat Flap Graft. Postoperative patient progress, it was successful developing no Systemic Complications nor Ischemic Signs in the Right Upper Limb being discharge for Out-Patient follow-up once the Surgical Wound conditions allowed and a Duplex-Ultrasound on late postoperative confirm normal blood flow conditions through the By-pass and distal limb.
Discussion: In our patient Restoration of Brachial Veins continuity and blood flow it was impossible because of external resources related factors and then Brachial Veins Ligation decided, based on what our next decision was to preserve the Basilic and Cephalic Veins for Upper Limb Collateral Venous Return harvesting a segment of one Brachial Vein long enough as conduit for the Arterial By-Pass instead the Great Saphenous Vein which would imply unnecessary delay in the procedure. By the other hand we use a Rotational Skin and subcutaneous Fat Flap Graft for wound closure ensuring proper coverage of the conduit and no compartment increased pressure.
Conclusion: This approach of Brachial Artery and Neurovascular Pedicle Traumatic Transection can be technically conducted with success and a non-reparable Brachial Vein used as autologous by-pass conduit preserving Superficial Upper Limb Venous network to avoid perfusion compromise because of Deep Veins Ligation in a setting of no possible Deep Vein repair.
Keywords: Brachial Artery Trauma; Brachial Vein Trauma; Brachial Vein Ligation; Autologous By-Pass; Opened Elbow Dislocation; Rotational Flap Graft
Citation: Yuniel Hernandez Castillo. "Use of A Brachial Vein Conduit and A Rotational Skin Flap Graft Repairing A Vascular Trauma".Acta Scientific Medical Sciences 4.1 (2020): 14-21.
Copyright: © 2020 Yuniel Hernandez Castillo. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.